2. Phone *

3. Email Address *

4. Postcode *

5. How did you hear about us? *

6. Wax/ Tint Agreement and Consent Form

Waxing certain areas can be uncomfortable. We attempt to minimise discomfort by waxing with a professional technique. Additionally, there are also steps that can be taken before the procedure such as taking ibuprofen or other oral analgesic before the proce- dure. Please tell us if there is anything we can do to make your waxing experience more comfortable. In addition, sensitive skin can be burnt from waxing procedures. Accutane and Retin-A or Tretinoin dry out the skin therefore, waxing may lead to removal skin and may cause scarring. Waxing over sunburned or very tanned skin may lead to removal of the skin, which may cause scarring. Diabetics have a very hard time healing when a wound or lesion occurs to the skin as the immune system is unable to function fully to fighting bacteria. Allergies to any of the product ingredients used in waxing may cause severe allergic reactions.

I have allergies.

I am currently taking Accutane

I am currently using Retin-A/ Tretinoin/ Renova/ Acne Medicine.

I have been waxed before today.

I have been diagnosed with diabetes.

7. Description of allergy (if any):

I confirm (to the best of my knowledge) that the information I have provided is accurate and complete. I have not withheld any information that may be relevant to my treatment and/ or the results thereof. I am aware that there often inherent risks associated with skin care services including waxing procedures, and that the services I am about to receive could have unfavourable results including, but not limited to: allergic reaction, irritation, burning, redness, scarring, soreness, etc. By signing below, I further agree that I will not hold USFIN ATELIER or any of employees responsible should there be any unfavourable outcome or result.